NPIMap

Organization Active NPI

Total Renal Care, Inc.

Doing business as Bountiful Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bountiful, UT
National Provider Identifier
1184387516
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE, INC.
Doing business as
Bountiful Dialysis
Practice address
532 S 500 W
Bountiful, UT 84010-7208
Phone
(385) 300-2657
Fax
(385) 489-0294
NPI assigned
Oct 21, 2021
Last updated
Sep 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samuel Wey
Title
VP Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

532 S 500 W
Bountiful, UT 84010-7208

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other names 1

  • Bountiful Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211122003094 UT Part A Provider - End-Stage Renal Disease Facility (ESRD) 0749473072 Practice locations: Bountiful, UT

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Bountiful DialysisCCN 462521
Overall star rating
5.0 of 5
Ownership
Profit
Certified
Dec 22, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
12

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0953427Bountiful Dialysis532 S 500 W, Bountiful, UT 84010Certificate of waiverNov 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Member organizations 206

Organizations listed as members of this organization in the National Provider Directory.

  • Hegan Dialysis, LLC

    dba Orem Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Orem, UT
    • NPI 1053956391

    Member Of

    NPD member
  • Pomme Dialysis, LLC

    dba Traverse Point Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Lehi, UT
    • NPI 1811554124

    Member Of

    NPD member
  • Wakonda Dialysis LLC

    dba Mt Nebo Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Salem, UT
    • NPI 1992223556

    Member Of

    NPD member
  • Able Dialysis LLC

    dba Providence Square Home Training

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Broomall, PA
    • NPI 1417389321

    Member Of

    NPD member
  • Adiron Dialysis LLC

    dba Melrose Park Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Melrose Park, IL
    • NPI 1841857430

    Member Of

    NPD member
  • Aikens Dialysis LLC

    dba Lincoln City Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Lincoln City, OR
    • NPI 1841787934

    Member Of

    NPD member
  • Alenes Dialysis LLC

    dba Hillsborough Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Hillsborough, NJ
    • NPI 1952761181

    Member Of

    NPD member
  • Arbela Dialysis LLC

    dba San Marino Home Training

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • San Marino, CA
    • NPI 1659997112

    Member Of

    NPD member
  • Avertrail Dialysis LLC

    dba Salt Creek Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Villa Park, IL
    • NPI 1912482654

    Member Of

    NPD member
  • Barrons Dialysis LLC

    dba Beach Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Stanton, CA
    • NPI 1144721770

    Member Of

    NPD member
  • Bear Creek Dialysis Center LP

    dba Bear Creek Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Houston, TX
    • NPI 1982650974

    Member Of

    NPD member
  • Birch Dialysis LLC

    dba Hilliard Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Rocky River, OH
    • NPI 1801192018

    Member Of

    NPD member
View all 206

Locations

532 S 500 W
Bountiful, UT 84010
Phone (385) 300-2657

Networks

  • UT PPO D-SNPPlans: DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) (H4473-004-000, H4473)

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1184387516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 S 500 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107208",
            "telephone_number": "385-300-2657",
            "fax_number": "385-489-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bountiful Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bountiful Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.